| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
646 |
586 |
$55K |
| 92015 |
Determination of refractive state |
730 |
647 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
92 |
88 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
161 |
136 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
116 |
105 |
$5K |
| 92341 |
|
68 |
67 |
$4K |
| 76519 |
|
12 |
12 |
$370.84 |